Four Dots, and Wow! You’ll Menstruate Every Three Months

Currently airing during Desperate Housewives and Saturday Night Live, the peppy commercial for the birth-control pill Seasonale begins with a cute brunette sashaying toward the viewer, her strapless white dress spotted with magenta circles. “What if someone told you there was a new possibility in birth-control pills?” asks a husky, disembodied female voice. “That now there’s a daily pill that lets you have just four periods a year?”

The brunette twirls around in excitement, the magenta color forms molting from her dress as the skirt fills with air.

The commercial continues, answering its own question repeatedly with “Yeahs” that punctuate the rockin’ background music, and lots of fist-pumping from our protagonist. As she spreads the word to other pleasant-looking, white-clad twentysomething women, they too jump at the chance to shed their “periods” by shaking them off a floating chiffon train (virginal-bride subtext alert!), flinging the excess discs like Aerobees and efficiently peeling them off a wall the way they would satisfactorily remove a Post-It to mark a completed errand, leaving only four hot pink “periods” behind. Then comes the tagline: “Fewer periods. More possibilities.”

Though the word “pill” is repeated several times throughout the ad, casual viewers could be forgiven for concluding that the commercial is marketing a new drug, a kind of “period reducer.” In fact, Seasonale, which has been available for 13 months, is a birth-control pill constitutionally no different from many others: It contains the same varieties and dosages of estrogen and progestin as Nordette.

Seasonale’s parent company, Barr Pharmaceuticals (based in Woodcliff Lake, N.J.), owns not the patent on the hormone pills themselves-that belongs to Nordette’s parent company, King Pharmaceuticals-but the patent on the concept of pounding those particular hormones for 84 days straight. After this interval, the patient is instructed to take inert pills for seven days to prompt a kind of reassuring faux menses-known as “withdrawal bleeding”-a concept familiar to the regular Pill taker, who experiences it 13 times a year.

Barr is the largest supplier of generic birth control in the United States-they manufacture 20 different kinds of pills-but Seasonale is their first brand-name contribution to the market. The concept was developed after the company’s internal research showed that “about seven out of 10 women who are on oral contraceptives would be interested in the option of having four periods a year,” said Amy Niemann, Barr’s vice president of marketing for proprietary products. “The women that we’ve talked to say that four sounds like a very good frequency; it’s just kind of a time to ‘check in.'”

But an unscientific sample of New York women polled by The Observer didn’t seem interested at all in this “option”-in disposing of that monthly flow that Simone de Beauvoir called “the essence of femininity.”

“I personally do feel that my period is an inconvenience, but it is part of my biological self, and I do feel like there’s something wonderful about it,” said Mia Dunleavey, 38, a writer who lives in Williamsburg. “Doing away with it I find really unappealing.”

Jodi Young, 40, a comedian living in the East Village, said that she found the whole thing “horrifying.”

“If you’re too busy to deal with your period once a month, or it’s that much of an inconvenience, then how far would you go not to be inconvenienced?” she said. “Why not just a full hysterectomy so you don’t have to deal with it at all!”

“It’s being marketed as a lifestyle drug, and it’s not a lifestyle drug,” said Dorre Fox, 35, an editor at American Baby who lives in Brooklyn Heights. “It’s something that seriously alters the chemicals in your body.”

At chic apothecary C.O. Bigelow in the Village, pharmacist David Manning said his staff had dispensed only 34 packs of the 91-day Seasonale regimen in the past 13 months. “It’s not a big mover; it’s a very, very, very slow-moving drug,” he said. “We don’t do much of it at all, and we do a lot of prescriptions.” Uptown at Clyde Chemists on Madison, supervising pharmacist Howard Schwartz said purchases of Seasonale had pretty much stalled. “The movement on it is very slow-below expectations,” he said.

Barr’s vice president of corporate communications, Carol Cox, said almost 500,000 prescriptions have been filled since the drug became available last September, but she wouldn’t specify how it was doing in New York City. Another publicist working for Barr arranged (and listened in on) an interview with Jersey City resident Jill Pearson, 30, who has been on Seasonale since the product’s inception and is pleased with her experience. But more than a year after Ms. Pearson started the regime, she remains the only one among her friends taking Seasonale. “I’ve never met anyone else who is on it,” she wrote in an e-mail after the phone interview.

Bigelow’s Mr. Manning has a theory. “This city runs on convenience,” he said, and with Seasonale, “the absolute daily convenience has not been increased. They still got to take a tablet every day!”

Barr wouldn’t reveal how much it is spending on the slick Seasonale campaign, which also features print ads in Lucky and Marie Claire magazines. But they don’t seem to be having the desired effect, at least among skeptical Manhattanites.

“Ugh … I’m 32 years old and I’m thinking, ‘Why mess around with your body?'” said Jamie Coles, an advertising account executive who lives in the Gramercy Park area and was distressed by the ad.

“It kind of works at the psyche,” said Ms. Young, the comedian. “You’re making a woman feel that the one thing that defines femininity … making it fashionable to be ashamed of it.” She compared Seasonale to “Soylent Green for the womb”-referring to the 1973 science-fiction film about a synthetic foodstuff with nefarious origins-“in the way that it’s marketed as being really positive, and the thing that women would want, but the thing that you don’t know about.”

“There’s a lot of hatred of women’s bodies in our culture,” said Claire Cavanah, 40, an owner and co-founder of the Lower East Side sex-gadgets shop Toys in Babeland. “This suppressing nine of the 13 already artificial periods seems like another expression of that to me, too. I think women are a little bit more accepting, and even celebrating, of their bodies and all the natural things that our bodies do. And technology’s going in the other direction.”

Or is technology bringing us back to where we began? In recent years, as reported by Malcolm Gladwell in The New Yorker, doctors and anthropologists have begun to suggest that monthly periods are neither natural nor necessary for women who are not trying to conceive. They point to Pill inventor John Rock, who established the 13-periods-a-year pattern not as a protective health measure, but in order to convince the Pope that using the Pill was an extension of the rhythm method of contraception (an average cycle is 28 days). Those supporting this view often cite studies showing that more menstrual cycles (which, naturally, are experienced by women who delay childbirth) are associated with higher rates of ovarian cancer.

“I haven’t had a period in years. I certainly feel comfortable with all of this as a concept,” said Dr. Shari Brasner, 39, an attending physician and OB-GYN at Mount Sinai Hospital who has prescribed Seasonale to about 10 patients, and has at least another 10 that have been on continuous pill packs of other brands. “When Seasonale got F.D.A. approval, it was just: ‘Oh yeah, great, you guys figured out what I figured out years ago.'”

On the other side are old-school feminists who are alarmed by the movement to suppress menstruation, likening it to a Dark Ages mentality when a woman’s period was considered a “curse.”

“They’re very alluring ads,” said Barbara Seaman, a veteran women’s-health activist who lives on the Upper West Side-and she didn’t mean that as a compliment. “Quite brilliant-an innocent young woman who has no idea about the dangers. It’s just some sort of crazy male fantasy.” She also raised the concern that women taking Seasonale might not know that they’re pregnant until three months later, when their period doesn’t arrive. “It’s really putting women up the creek in that respect,” said Ms. Seaman, author of The Doctor’s Case Against the Pill (Hunter House, 1969). (Dr. Brasner countered that the Pill is “a very effective form of birth control.”)

Ms. Seaman also pointed to higher rates of “breakthrough bleeding”-unexpected periods-that the Seasonale ad acknowledges. “This whole thing is a joke,” she said. “You’re taking this so you don’t bleed, but then you bleed more than people on the regular Pill!” (Seasonale literature claims this side effect tends to “decrease during later cycles.”)

Dr. Barbara Rako, a psychiatrist who authored the book No More Periods: The Risks of Menstrual Suppression, (Harmony, 2003), pointed to studies showing increased cervical-cancer rates for women on birth-control pills (the American Cancer Society’s Web site calls this a “very slight potential risk”); the potential for testosterone deficiency, which lowers libido and general metabolic health; and the lack of longitudinal studies on Seasonale.

But the ideal of “no more periods”-though it’s unclear, exactly, whose ideal this is-continues to engross corporate masterminds. Next year, Wyeth Pharmaceuticals plans to apply for F.D.A. approval on Librel, a pill you officially take every day-Seasonale without the seasons.

“You can’t go from a culture that expects 12 periods to zero with no stepping stone,” said Dr. Brasner, the Mount Sinai gynecologist. “Seasonale is that stepping stone.”

Four Dots, and Wow! You’ll Menstruate Every Three Months